Article

Passive range of motion has proven itself as a useful treatment modality for increasing or maintaining range of motion of the hip, knee, ankle, shoulder, and elbow. Clinically, we have observed improved wound healing and reduction of edema. Septic joints that are or have been opened and drained appear to clean up sooner than joints treated with only incision and drainage (I & D) and daily whirlpool. Patients are comfortable with reduced requests for pain medications. Patients also seem happier and this may be due to the fact that something is being done to help them get better on a continuous basis. Therapy time can now be devoted to improving muscle control and independant activity levels rather than painful ROM exercises. Of the 168 cases presented in this paper, all but two patients did or would have benefited from passive mobilization. The degree of success depended to a large extent on patient compliance All patients who cooperated with this treatment modality improved their motion and reduced their hospitalization with two exceptions. One patient had undergone total knee replacement and was placed in CPM in the recovery room. Approximately 20¡ of motion was achieved initially. All attempts to increase her motion failed in that the 3 D device would stall at a given point and reverse itself. The referring physician was contacted in order to report the difficulties. It was learned that the patient, some 40 years earlier had undergone a spontaneous hip fusion probably due to infection. Conventional CPM can not be utilized for ROM of the knee if the hip is immobilized. The second failure was with a young sickle cell disease patient also having severe sepsis of the knee. All attemps of passive mobilization were painful and limited to less than 30¡ of flexion. The patient underwent arthrodesis of the knee and was later discharged with granulating wounds. Patients with fractures involving articular surfaces of the knee have done well with 0-90¡ of pain free active motion obtained in generally less than ten days. Depending on the degree of internal fixation or patient compliance, a cast brace was applied prior to discharge. As stated earlier, cast bracing and passive mobilization is a common treatment modality.

Langue : ANGLAIS

Identifiant basis : 1985001532